간호사-지역사회 건강상담자 팀의 미국 도시지역 젊은 흑인 남자 집단의 고혈압

Abstract

Young black men(YBM) have the most severs levels of high blood pressure(HBP) and, in all reports but one, the lowest of HBP control of any age /sex /race group. To increase entry into care, remaining in care, and BP control for young(18-49 years) Black men, It is needed to review socio—demographic, medical characteristics, and behaviors (importance of and difficulty with HBP control behaviors, or worry about mdication)for experimental intervention study(educational-behavior strategies) of hypertensive urban young black men. The 204 participants had an average age of 38.8+7.0 years and an average educational level of 11.0土2.4 years ； only 23.1% were employed full- or part-time while 26% were on disability ； and 6% were married. Only 35.3% had an MD for HBP care and 37.3% had some form of health insurance. The average BP of those men currently being in care on medication (35.3%) was 148.2/95.1 土 19. 5/11.3 compared to those men not taking HBP care 153.7/99.1土14.0/9.8(p<.05〉. The average creatinine level was 1.3(excluding 3 marked elevations of 15.9’ 9.6，and 7.7) for the 163 men consenting to have their blood drawn. Self-reported co-morbidity included heart disease 7.8%，diabetes 8.9% high cholesterol 18.2%， CVA 3.4%, alcohol and drug related problems 27.9% and 22.5% respectively. The kidney disease of those men currently being in care & on medication was 9.7 compared to those men not taking HBP care 0.8(p< .05). The problems of with sex life, physicl activity and clearly thinking of those men currently being in care & on medication was higher compared to those men not taking HBP care(p<.05). Questions of "during the past month, on how many days did you have 5 or more drinks(bottles) of any alcoholic beverag?" and smoking of those men currently being in care & on medication was 18.1% and 72.2% compared to those men not taking HBP care 27.3 and 82.6% respectively. HBP control behaviors was assessed with 1—5 point Likert subscales(5=extreme, 1 — none at all). In general, th men reportd low levels of perceived psychological barrier to HBP care and control behaviors ； importance of and difficulty with HBP control behaviors, or worry about mdication. For example, on a five point scale (l=none at all, 5=extreme), average ratings for perceived important and difficulty with BP care and behaviors were 2.8(SD=1.2) and 2.5(SD=1.1). Aver\-age ratings for perceived benefit with BP care and behaviors worry about medication of those men currently being in care on medication was 4.0(SD=0.9) and 2.2(SD=1.1) compared to those men not taking HBP care 3.6(SD=0.8)，2.8 (SD=1.6) respectively(p<.05). These data support the need for educational — behavioral strategies of community health nurse to improve high blood pressure control in this high risk group through perceived barriers to treatment, health care skills and use of resources, and social support.